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PURPOSE: Asymptomatic primary hyperparathyroidism (aPHPT) has been recognized as a condition that can lead to renal complications. Timely identification of prognostic indicators for renal impairment holds the potential to facilitate proactive monitoring and treatment strategies in these patients. This study aims to investigate the utility of acoustic radiation force impulse (ARFI) imaging and renal resistive index (RRI), in identifying renal parenchymal and vascular changes in patients with aPHPT. METHODS: Forty-two patients with aPHPT and 42 controls matched for age, sex, and body mass index were included in the study. The presence of renovascular changes was evaluated by RRI measurement with Doppler ultrasonography, and the presence of renal parenchymal involvement was evaluated by ARFI quantification, given as shear wave velocity (SWV). RESULTS: In aPHPT patients, both the mean RRI and mean SWV values exhibited substantial elevation compared to the control group (P < 0.001 for both). Significant associations were observed between SWV values and serum calcium, parathyroid hormone (PTH), and adenoma size within the patient group (P < 0.001, P < 0.001, P = 0.016, respectively). Similarly, the mean RRI demonstrated positive correlations with serum calcium and PTH levels in the patient group (P< 0.001, P = 0.011, respectively). Multivariate linear regression analysis underscored the connection between mean RRI and mean SWV values with serum calcium levels within the patient group. In addition, serum PTH levels affected mean SWV positively and significantly. CONCLUSION: The use of ARFI imaging and RRI measurements appears to hold potential in identifying renal involvement in patients with aPHPT.
Asunto(s)
Hiperparatiroidismo Primario , Humanos , Femenino , Masculino , Hiperparatiroidismo Primario/diagnóstico por imagen , Hiperparatiroidismo Primario/complicaciones , Persona de Mediana Edad , Pronóstico , Estudios de Casos y Controles , Diagnóstico por Imagen de Elasticidad/métodos , Riñón/diagnóstico por imagen , Riñón/patología , Ultrasonografía Doppler/métodos , Adulto , Anciano , Hormona Paratiroidea/sangre , Enfermedades Asintomáticas , Enfermedades Renales/etiología , Enfermedades Renales/diagnóstico por imagen , Enfermedades Renales/diagnósticoRESUMEN
BACKGROUND: Computer-aided detection in the setting of trauma presents unique challenges due to variations in shape and attenuation of the injured organs based on the timing and severity of the injury. We developed and validated an automated computer-aided diagnosis algorithm to detect splenic lesions such as laceration, contusion, subcapsular hematoma, perisplenic hematoma, and active extravasation using computed tomography (CT) images in patients sustaining blunt or penetrating abdominal trauma. METHODS: We categorized the splenic pathologies into three groups: contusion/laceration, hematoma, and active extravasation. We first analyzed the spleen and perisplenic region by estimating the mean value and standard deviation of the spleen. We determined adaptive threshold values based on the histogram of the area and detected the lesions after morphological operations and volumetric comparisons. RESULTS: The overall performance of the three computer-aided diagnosis (CAD) algorithms is an accuracy of 0.80, sensitivity of 0.95, specificity of 0.67, and a diagnostic odds ratio (DOR) of 40 with a 95 % confidence interval (CI): 14 to 117. The CAD of perisplenic hematoma had the highest diagnosis rates with an accuracy of 0.90, a sensitivity of 0.95, specificity of 0.80, and DOR of 76 with a 95 % CI: 13 to 442. CONCLUSIONS: We developed a new algorithm to detect post-traumatic splenic lesions automatically and with high accuracy. Our method could potentially lead to the automated diagnosis of all traumatic abdominal pathologies. HIPPOKRATIA 2018, 22(2): 80-85.
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INTRODUCTION: Our purpose was to determine whether diffusion-weighted MR imaging (DWI) could be used in differentiation of benign and malign breast lesions. MATERIALS AND METHODS: 41 women patients were included in the study. 45 lesions were diagnosed by biopsy; 25 (55.5%) of these lesions were malignant and 20 (44.5%) were benign. The apparent diffusion coefficient (ADC) values of these lesions were prospectively compared with their histopathological results. RESULTS: Differentiation of the malignant and benign masses revealed that the threshold value of the ADC was 1.0 x 10(-3) mm(2)/s, its sensitivity was demonstrated as 95%, specificity as 100%, positive predictive as 100%, negative predictive as 94% and accuracy rate as 97%. CONCLUSIONS: DWI improves diagnostic accuracy of the conventional breast MRI. ADC measurements may be useful for differentiation of the malign and benign masses.